肝移植后急性损伤发展为慢性病的发生率和危险因素:回顾性队列研究
Liping Li1, Jinxuan Dai1,2, Yiqian Liu3
1Department of Anesthesiology, The Third Affiliated Hospital of SunYat-Sen University, Guangzhou City, Guangdong Province, China.
概括
近30%的肝移植患者在急性损伤后发展为慢性病. 糖尿病,癌症和功能下降是这种进展的主要危险因素.
科学领域:
- 肝脏病学
- 移植医学
- 临床流行病学
背景情况:
- 肝移植后的急性损伤可能导致慢性病.
- 慢性病的进展会增加死亡率,住院时间和医疗费用.
- 鉴定 AKI 到 CKD 进展的风险因素对于患者的结果至关重要.
研究的目的:
- 在肝移植后,研究 AKI 进展为 CKD 的预后.
- 确定与 AKI 发展为 CKD 相关的独立风险因素.
主要方法:
- 在443名肝移植后AKI患者进行的回顾性队列研究.
- 分类为CKD和非CKD组.
- 多变量逻辑回归分析以确定风险因素.
主要成果:
- 在29. 3%的患者中,AKI进展为CKD.
- 慢性脏病的发展与1年死亡率显著上升 (4. 6%).
- 独立的风险因素包括手术前糖尿病,肝癌,SCr升高,AKD过渡/ 阶段,低EGFR;较高的HCT和AKD恢复降低了风险.
结论:
- 肝移植后 AKI 到 CKD 的进展是一个重大问题.
- 手术前的情况和早期的术后功能是关键预测因素.
- 针对已识别的风险因素可以缓解CKD的发展并改善长期存活率.
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